Epidemiologic Notes and Reports Measles on a
College Campus -- Ohio

Between January 15, and February 9, 1985, 12 confirmed cases of
measles among students at The Ohio State University have been
reported
to the Ohio Department of Health. Two cases have been
serologically
confirmed. The index case is a senior student who acquired measles
while traveling to London and Sierra Leone between December 8,
1984,
and January 5, 1985. His rash onset was January 15; he
subsequently
infected four additional students. To date, students in one
fraternity, one sorority, and three dormitories have been infected.
In addition, several students in a brother fraternity at
neighboring
Miami University of Ohio have been exposed to a potentially
infectious
student from The Ohio State University.

The student health service, assisted by the Ohio Department of
Health, has initiated several control measures, which include: (1)
holding voluntary vaccination clinics in affected dormitories and
at
the student health clinic; (2) publicizing the outbreak on campus
and
in the surrounding community; and (3) increasing surveillance on
campus and in the surrounding community. To date, 500 doses of
vaccine have been administered to the student body, which consists
of
approximately 50,000 students. Additional clinics are planned for
fraternity and sorority members.
Reported by DI Charles, MD, Director of Student Health Svcs, FW
Smith,
MD, Chief of Preventive Medicine, RJ Spillman, PhD, Vice Provost
for
Student Affairs, The Ohio State University, Columbus, TJ Halpin,
MD,
State Epidemiologist, Ohio Dept of Health; Div of Immunization,
Center
for Prevention Svcs, CDC.

Editorial Note

Editorial Note: Measles outbreaks on college campuses have been
reported with increasing frequency in recent years (1). In 1980,
1.5%
of all reported cases occurred on college campuses, compared with
19.8% of all cases reported in 1983. In 1984, one large outbreak
in
New Hampshire involved 29 students or their family contacts at
Dartmouth College, the community, and patients and staff at the
community hospital (2). The current outbreak has already involved
three generations, and additional spread seems likely.

The propensity of measles to spread among college students is
related to several factors, the most important of which include:
(1)
many college-aged students may have missed measles vaccination in
the
first years following licensure of measles vaccine; (2) college
students tend to congregate in large groups (e.g., dormitories,
fraternities and sororities, and social and sporting events); and
(3)
many colleges and universities lack immunization requirements.
Since
approximately 5%-15% of college-aged individuals are currently
susceptible to measles when tested serologically (4), college
campuses
effectively become a gathering place where large pools of
susceptibles
congregate. Any introduction of measles virus is likely to spread
easily in such a susceptible population.

Measles outbreaks on college campuses are costly and
disruptive.
It is estimated that the Dartmouth outbreak cost over $30,000 to
control (2). The direct costs of controlling the 1983 outbreak at
Indiana University at Bloomington exceeded $225,000 (1).

Because it is more cost-effective to prevent measles outbreaks
than to attempt to control them (1), in May 1983, the American
College
Health Association adopted a preadmission immunization policy
recommending that, by September 1985, colleges and universities
require all students born after 1956 to present documentation of
immunity to measles and other vaccine-preventable diseases before
matriculation. A similar recommendation was made in 1980 by the
Immunization Practices Advisory Committee (5). Several
universities
have already implemented such policies. In Mississippi, students
registering for the first time at state-supported 4-year colleges
and
universities are required to furnish proof of immunity to measles
and
rubella. Currently, neither The Ohio State University nor the
other
affected colleges in Ohio have immunization requirements for
matriculating students.

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